Do you judge your overweight classmates?

[deleted480308]

No I didn’t.
I’m fat, pretty much always have been.
Yet I played a D1 sport in college, still play sports, run marathons, etc.
I mean even if I didn’t do that, you don’t know people’s lives so I don’t judge.
There’s already enough judgement and disrcimination that fat people face.
At 5’3 I’m never going to be 135 pounds unless I literally starve myself (have tried that and yes it was like I had an eating disorder). My weight doesn’t affect me being a compassionate and intelligent doctor.

I don’t know your muscle mass to determine if 135 is what it takes for you to not be “fat”, but you can totally be an appropriate weight without starvation. You aren’t so unique that the laws of physics don’t apply to you

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[deleted480308]

Did that affect your opinion of him/her? By calling it a stupid decision, it sounds like it did, at least a little.

I’ll bite. I totally judge to decision the use the first time. It’s stupid.

Continuing becomes a more complex decision process.

Judgement gets a bad rap, some things deserve some judgement

 

[CidHighwind]

“Overweight” is relative and also depends on race. If you are Asian, you need to be a lower bmi to be considered a healthy weight. If you are black, you can be a slightly higher BMI and still be considered a healthy weight.

Ethnic Differences in BMI and Disease Risk

The chance of developing diabetes, heart disease, and other weight-related health risks increases with increasing body mass index (BMI). But theres strong evidence that at any given BMI, these heal…

www.hsph.harvard.edu

Just has to do with muscle mass. BMI was based on whites. Asians have less muscle on average so a lower BMI makes sense. Opposite with blacks. Just use bodyfat and stop this BMI nonsense

 

[Sephirakra]

Honest question for those who said they wouldn't judge a colleague for being overweight: Would you judge a colleague that had a heroin addiction?

That's a piss-poor comparison. People need to eat, exercise takes time and effort, and genetic factors can impact weight. No one needs heroin. As for someone who already has a heroin addiction, I don't think I could put it better than @sb247:

I’ll bite. I totally judge to decision the use the first time. It’s stupid.

Continuing becomes a more complex decision process.

Judgement gets a bad rap, some things deserve some judgement

 

[Matthew9Thirtyfive]

Did that affect your opinion of him/her? By calling it a stupid decision, it sounds like it did, at least a little.

Of course. We all are constantly altering our opinions of people as we interact with them. That's just how humans are. It was stupid for them to start, but I also don't know all the details. I don't think very many people say to themselves, "Hmm, I think I'll just randomly go try heroin today." Having played in the professional music scene for a while (which is where my family member got involved with heroin), drugs can be a big part of the culture if you get hooked into the wrong part of the scene.

So did my opinion of them change? Of course. But that doesn't mean I judged them for being addicted to heroin. It just means I think their initial decision was stupid, while recognizing that it was likely more complicated than deciding to try venison for the first time.

 

[IsleyOfTheNorth]

Here's my hypothesis: I think that people are so afraid of being judgmental that they ignore or downplay health issues to the detriment of their patients.

Further, I think that when a physician smokes a cigarette or remains obese I think they are communicating to the patient (intentionally or not) that the issue (smoking, overeating, etc.) is not as serious as it might otherwise be.

"If the expert is doing it, it can't be that bad."

 

[deleted480308]

Of course. We all are constantly altering our opinions of people as we interact with them. That's just how humans are. It was stupid for them to start, but I also don't know all the details. I don't think very many people say to themselves, "Hmm, I think I'll just randomly go try heroin today." Having played in the professional music scene for a while (which is where my family member got involved with heroin), drugs can be a big part of the culture if you get hooked into the wrong part of the scene.

So did my opinion of them change? Of course. But that doesn't mean I judged them for being addicted to heroin. It just means I think their initial decision was stupid, while recognizing that it was likely more complicated than deciding to try venison for the first time.

Since we’re going full disclosure, I also judge people for not trying venison

 

[IsleyOfTheNorth]

So did my opinion of them change? Of course. But that doesn't mean I judged them for being addicted to heroin.

That's what judgement is.

 

[Matthew9Thirtyfive]

Here's my hypothesis: I think that people are so afraid of being judgmental that they ignore or downplay health issues to the detriment of their patients.

Further, I think that when a physician smokes a cigarette or remains obese I think they are communicating to the patient (intentionally or not) that the issue (smoking, overeating, etc.) is not as serious as it might otherwise be.

If the expert is doing it, it can't be that bad.

I think maybe there might be a communication error here. We may be using different definitions for judgement.

That said, I do agree that if a physician is smoking or not making any attempt to lose weight when they are obese, it may have a negative affect on their patients' willingness to stop those things. "Do as I say, not as I do" doesn't really work. But again, we can't really know someone's story. Maybe they are trying to lose weight.

 

[Matthew9Thirtyfive]

That's what judgement is.

Ah, okay. So I was right. We are using different definitions. By judgment, I assumed you were using the term in a way such that "judging" someone means viewing them negatively based on whatever quality you are judging. If you mean it in the neutral sense of forming an opinion about someone, whether positive or negative, then yes.

 

[deleted407021]

Food is absolutely a central point of entertainment, pleasure and cultural significance all over the world. This isn’t the reason it’s harmful in excess.

A dietician I worked with emphasized how she chose that job because she loved food and cooking and wanted to share that with people in a helpful, healthy way.

 

[IsleyOfTheNorth]

Food is absolutely a central point of entertainment, pleasure and cultural significance all over the world. This isn’t the reason it’s harmful in excess.

So is alcohol, and yet we wouldn't advise alcoholics to hang out in bars.

If obesity is an issue for someone, I would advise them not to think of food as a source of entertainment.

 

[ExcitatorySynapse]

Food can be healthy and tasty too; I don't disagree. However, it's dangerous to put food as a central pleasure.

Anecdotally, I’ve found that the less I enjoy food, the easier it is to eat healthy and adhere to whatever macro goals etc. I’m trying to reach. When I saw food as a source of joy, I was definitely less healthy (and no more happy). I don’t think it’s an easy mentality to change, though.

 

[IsleyOfTheNorth]

Anecdotally, I’ve found that the less I enjoy food, the easier it is to eat healthy and adhere to whatever macro goals etc. I’m trying to reach. When I saw food as a source of joy, I was definitely less healthy (and no more happy). I don’t think it’s an easy mentality to change, though.

Speaking from experience, this is very much the case with the poor in the US. So many poor in the US are obese because unhealthy food is such a cheap source of pleasure.

 

[Alkaidius]

Speaking from experience, this is very much the case with the poor in the US. So many poor in the US are obese because unhealthy food is such a cheap source of pleasure.

I would love to see BMI data from the very moment fast food became a thing. But I bet you Ronald has that info sealed tight behind multi-million dollar "donations".

 

[deleted407021]

So is alcohol, and yet we wouldn't advise alcoholics to hang out in bars.

If obesity is an issue for someone, I would advise them not to think of food as a source of entertainment.

That’s absolutely not going to change anyone’s conception surrounding food.

 

[KeikoTanaka]

More than 60% of America is overweight, will be 80% by the time I begin practicing in 6 years. Judge them? Literally I would get tired or won't have the mental endurance to keep judging every person who is overweight.

People need to do things they love. Everyone should have/find a passion or hobby that requires some physical exertion. Whether that be shopping, walking the dog, anything.

Even if you don't lose weight, 30 minutes of exercise a day can lower LDL, increase HDL, and reduce CAD and stroke risk by 60% WITHOUT EVEN LOSING WEIGHT. The mere physiologic effect of working out / exercising is enough to do that. So, no, don't judge people for being overweight. Encourage a hobby that can make them be active, and hope that sticks.

I know I'm talking about the lens of patients here when I say this, and the question is posed to classmates - but in all honesty, the reason so many of my classmates are NOT overweight is because the average medical student does not reflect the current population of America.

Believe it or not, we're a very privileged group, and most of us come from wealth, and if not wealth, then at least a strong middle class family with a strong sense of values and community. That translates to a fitter / attractive group of medical professionals. So, yes, the 4-10 overweight people in the class might stand out like a sore thumb, especially when we all take off our shirts in the OMM lab, but, no, just as I would get tired judging 80% of America for being overweight, I don't judge the overweight kids in my class.

 

[IsleyOfTheNorth]

That’s absolutely not going to change anyone’s conception surrounding food.

It changed my perception of food. When I stopped viewing food as a source of entertainment I lost weight.

 

[AMEHigh]

No disrespect intended, but that sounds like an excuse. If you ate nothing but steamed, low starch vegetables and egg whites you would be under 135 pounds and not starving (unless you count any weight loss as "starving").

Yes I would be very hungry, hence the use of the word starving which means suffering from hunger. I also would not be able to workout or be productive during my day due to lack of calories. I have done this, so no this is not an excuse, it is a fact for my body.

My body is not meant to be 135 pounds unless I’m literally supposed to sit around doing nothing except eat 1100 calories and not exist in life. Hence me saying I would be starving. In case you have made it through life without recognizing that different people have different body frames and shapes then you probably should not be in medicine.

 

[odyssey2]

It changed my perception of food. When I stopped viewing food as a source of entertainment I lost weight.

I don’t think it’s an either or situation. I go through cutting and bulking phases and am aware of my diet as it relates to my body goals, but I also know if I adopted an incredibly spartan diet it wouldn’t last in the long run. I’ve adjusted my lifestyle slowly over the years to something healthy which I can still enjoy. My problem is telling people a healthy diet is a miserable diet, I think this puts more people off the track of eating healthier.

 

[IsleyOfTheNorth]

Yes I would be very hungry, hence the use of the word starving which means suffering from hunger.

If you eat 4 pounds of steamed soy beans every day, you won't be hungry. If you eat 3 heads of lettuce and you're still hungry, see a neurologist.

I also would not be able to workout or be productive during my day due to lack of calories.

This is where self-discipline comes into play. Your body has calories available and it will convert those calories to energy when you need it. You will be tired - especially if you go to extremes (which is not advisable). Eat fewer calories then you burn and you will lose weight. If you still don't lose weight, see a physicist.

... it is a fact for my body. ... My body is not meant to be 135 pounds ...

What do you say to someone who says "My body isn't meant to be less than 400 pounds?"

 

[AMEHigh]

Also it’s very rare that men especially take in to account the affect that hormones have on our weight as women throughout a lifetime. Between menses, having kids and breastfeeding (if one chooses to do so), peri-menopause and menopause there are so many factors that affect the ability to lose weight that aren’t acknowledged, even by doctors.
Biologically there’s a reason that women in general have more body fat percentage than men.

 

[IsleyOfTheNorth]

Also it’s very rare that men especially take in to account the affect that hormones have on our weight as women throughout a lifetime. Between menses, having kids and breastfeeding (if one chooses to do so), peri-menopause and menopause there are so many factors that affect the ability to lose weight that aren’t acknowledged, even by doctors.
Biologically there’s a reason that women in general have more body fat percentage than men.

I don't think it's very rare, but yes, men and women have different healthy body fat percentages. That doesn't mean that obese people can't lose weight.

 

[AMEHigh]

If you eat 4 pounds of steamed soy beans every day, you won't be hungry. If you eat 3 heads of lettuce and you're still hungry, see a neurologist.



This is where self-discipline comes into play. Your body has calories available and it will convert those calories to energy when you need it. You will be tired - especially if you go to extremes (which is not advisable). Eat fewer calories then you burn and you will lose weight. If you still don't lose weight, see a physicist.



What do you say to someone who says "My body isn't meant to be less than 400 pounds?"

I see you’re just being a troll so I’m going to ignore you.
While everyone is freaking out about usmle becoming pass/fail we still haven’t figured out how to screen out people who aren’t intelligent and aren’t empathetic.

 

[Alkaidius]

I'm not a fan of the "fat acceptance" movement, mainly because I just have this suspicion that it's being orchestrated by the fastfood illuminati, but also because I've realized American culture centers are immediate gratification. It's much easier to feel momentarily elated by eating a slice of chocolate cake than by going through a 2 hour exercise routine.

What needs to be understood is that weight loss/maintenance and health is going to be a battle against yourself for your entire life. Cheat days are fine, but you gotta balance that out with a salad or something. I don't think people understand that it's a journey, not a destination. Or if they do, it scares them into apathy.

 

[Pepe18]

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[Mass Effect]

Honest question for those who said they wouldn't judge a colleague for being overweight: Would you judge a colleague that had a heroin addiction?

Would I, as a physician, judge a colleague for having an illness? No, no, I wouldn't. Why do you ask?

No disrespect intended, but that sounds like an excuse. If you ate nothing but steamed, low starch vegetables and egg whites you would be under 135 pounds and not starving (unless you count any weight loss as "starving").

While you're concerned about what we're telling patients, the above post makes me concerned about what YOU'RE telling patients.

 

[deleted407021]

It changed my perception of food. When I stopped viewing food as a source of entertainment I lost weight.

Cool. Giving people fewer things to enjoy isn’t liable to work in most cases. For you, that may have been a good solution but for many of my patients, in the South, asking them to reduce the importance of food is like asking them to abandon their culture.

 

[nimbus]

The fact is that a lot of people can maintain a healthy weight with zero effort. I was 5’8” and 120-130 for most of my adult life. I eat dessert and drink soda with every meal. Only in my 50’s has my weight increased to 150. So I don’t judge others.

 

[Mass Effect]

If you eat 4 pounds of steamed soy beans every day, you won't be hungry. If you eat 3 heads of lettuce and you're still hungry, see a neurologist.

I can't believe you actually typed those words.

 

[Alkaidius]

Cool. Giving people fewer things to enjoy isn’t liable to work in most cases. For you, that may have been a good solution but for many of my patients, in the South, asking them to reduce the importance of food is like asking them to abandon their culture.

That damn sweet tea...you'd think they see it as the blood of Christ...

 

[Sephirakra]

That damn sweet tea...you'd think they see it as the blood of Christ...

Even that's supposed to be drunk in moderation...

 

[deleted407021]

That damn sweet tea...you'd think they see it as the blood of Christ...

Right. It’s just not going to happen. But, I think it’s much more likely we can instill a virtue of moderation in our patients.

 

[deleted407021]

To answer the thread question, not really. I judge myself more for having a BMI of 25.8 than my talented, clinically astute classmates who might be 35 or something.

 

[deleted407021]

Sometimes this whole forum belongs on the AITA subreddit.

 

[medhopeful82]

The fact is that a lot of people can maintain a healthy weight with zero effort. I was 5’8” and 120-130 for most of my adult life. I eat dessert and drink soda with every meal. Only in my 50’s has my weight increased to 150. So I don’t judge others.

wow, I envy your metabolism so much.

To answer the original question, I don't judge overweight people, but I do slightly judge obese people (not saying it's correct, just my reality). I know how hard it is for me to maintain a BMI under 25 (sitting around 26 now) and not everyone wants to devote hours of their day to exercise and eating perfectly and thats okay.

 

[raiderette]

I don't judge, but I am curious about them. I grew up poor, so I equate obesity with lack of nutrition, education, options, and I don't look down on my friends and family members in general.
I am often surprised to see wealthy people with weight issues because they have the resources to deal with it, the recreational time to exercise, etc.

 

[VA Hopeful Dr]

In case you have made it through life without recognizing that different people have different body frames and shapes then you probably should not be in medicine.

Don't do that. We can disagree without that sort of thing.

 

[mwsapphire]

Ive historically used food as reward/punishment. First year, i was living off like 500 calories a day and i lost 25 lbs (i was under 100 lbs at one point)

and now, my BMI is right about 25. And i HATE it.

Oh geez. See that makes me scared for med school. And 25? that's the boundary between normal and overweight- I think there needs to be a 10 lb buffer for over/underweight based on body skeletal built - there is evidence to suggest the BMI scale is skewed toward fine-boned folks, and may even be favoring tall/lean white individuals and not taking heavier skeletal structure into account.
And @Matthew9Thirtyfive "slightly fluffy side" haha so cute. I'm not a med student but this title caught my eye in trending.

 

[Alkaidius]

Oh geez. See that makes me scared for med school. And 25? that's the boundary between normal and overweight- I think there needs to be a 10 lb buffer for over/underweight based on body skeletal built - there is evidence to suggest the BMI scale is skewed toward fine-boned folks, and may even be favoring tall/lean white individuals and not taking heavier skeletal structure into account.
And @Matthew9Thirtyfive "slightly fluffy side" haha so cute. I'm not a med student but this title caught my eye in trending.

I'm not fat! I just have a thick skull...I mean, nobody really cares about the 26-30 crowd, they're sorta in no-man's land. Especially if they've been stable there for years.

"Forty, Female, Fertile, Fluffy" will be stamped on your forehead during GI block. You would do well to remember it.

 

[deleted859689]

People who are overweight can be physiologically healthy if they exercise. On the flip side, if your weight is “normal” but you live a bad life style (e.g. couch potato, smoker, etc) there’s a chance you’re less healthy than the overweight individual who exercises.

 

[ciestar]

Oh geez. See that makes me scared for med school. And 25? that's the boundary between normal and overweight- I think there needs to be a 10 lb buffer for over/underweight based on body skeletal built - there is evidence to suggest the BMI scale is skewed toward fine-boned folks, and may even be favoring tall/lean white individuals and not taking heavier skeletal structure into account.
And @Matthew9Thirtyfive "slightly fluffy side" haha so cute. I'm not a med student but this title caught my eye in trending.

Yeah 25 is the “overweight” cutoff.
as a first year, my BMI was as low as 17. My weight has fluctuated almost 50 pounds since i started.

I will say i do have underlying bipolar disorder that really contributes to all of this.

 

[TwoHighways]

All I can say is that the energy balance model grossly discounts the importance of the source of calories and the hormonal response we have to macronutrients.

 

[Matthew9Thirtyfive]

I'm not fat! I just have a thick skull...I mean, nobody really cares about the 26-30 crowd, they're sorta in no-man's land. Especially if they've been stable there for years.

"Forty, Female, Fertile, Fluffy" will be stamped on your forehead during GI block. You would do well to remember it.

We learned the slightly less PC “fat, female, fertile, forty” version.

 

[mwsapphire]

We learned the slightly less PC “fat, female, fertile, forty” version.

But do you think BMI 25 being OW is arbitrary?

 

[odyssey2]

But do you think BMI 25 being OW is arbitrary?

It definitely is, especially when it comes to the oft-quoted bodybuilders. Body fat percentage is definitely a way better tool

 

[mwsapphire]

It definitely is, especially when it comes to the oft-quoted bodybuilders. Body fat percentage is definitely a way better tool

But even a woman/man with a heavier skeletal structure, and body fat percentage can be arbitrary as well. Not necessarily a body builder.

 

[Matthew9Thirtyfive]

But do you think BMI 25 being OW is arbitrary?

Very. At my height, I'd only have to be 165 pounds to be overweight. That's absurd.

 

[AMEHigh]

Don't do that. We can disagree without that sort of thing.

Don’t do what? I stick by what I said. It’s highly problematic in regards to what that poster said. People not going to the doctor due to being shamed for being overweight and/or fat is 100% a problem. Myself and my friends have experienced it first hand and there is plenty of data on that. Their post said that I have no excuse for not being 135 pounds and should eat 3 heads of lettuce and not be hungry (let alone no mention of the nutrients one would be missing if they just ate lettuce). I don’t think a person who thinks like that should be a doctor because they clearly don’t understand how the human body works and how bodies are different. That kind of thinking is harmful to patient care.

 

[VA Hopeful Dr]

Don’t do what? I stick by what I said. It’s highly problematic in regards to what that poster said. People not going to the doctor due to being shamed for being overweight and/or fat is 100% a problem. Myself and my friends have experienced it first hand and there is plenty of data on that. Their post said that I have no excuse for not being 135 pounds and should eat 3 heads of lettuce and not be hungry (let alone no mention of the nutrients one would be missing if they just ate lettuce). I don’t think a person who thinks like that should be a doctor because they clearly don’t understand how the human body works and how bodies are different. That kind of thinking is harmful to patient care.

You don't know enough about someone based on a few internet posts to judge whether or not they should be a doctor.