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Comment by joenot443 | Hacker News Reader

I would say that your depression comparison isn't totally accurate.

There are safe, reliable, and well-understood ways to lose weight. They're not easy, enjoyable, or fast, but they're almost certain to work, excluding other medical conditions.

Depression on the other hand, is far less well understood. It's also far more more difficult to treat and fight, and while weight loss has an effective general solution of eating less and exercising more, no such general solution exists for depression. Plenty of people spend their lives chronically depressed with little to no improvement, despite trying countless medications, forms of therapy, and lifestyle adjustments. The same can't really be said for weight loss.

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That's not quite the point I am making. The point is that taking either condition at its most surface level and just saying "why don't you just fix it?" is unhelpful.

The fact that there are known ways to help solve weight loss isn't the problem. Obese people know there are ways to lose weight. The issue is psychological - not believing one can achieve the goal, not being ready/willing to fully commit to the goal, feeling too ashamed of oneself to believe one can improve one's situation, and on and on.

Plus, you suggest that because the way to lose weight is clear (it is), that makes it easy. That's a false equivocation. I'm speaking from experience when I say it's simple, but quite challenging. That's like saying "winning the Olympic 100m sprint is easy, just be faster than everyone else." (No, I don't think my weight loss is an Olympian effort, but I am exaggerating for effect.)

> Plus, you suggest that because the way to lose weight is clear (it is), that makes it easy.

> > There are safe, reliable, and well-understood ways to lose weight. They're not easy

The poster you are replying to specifically said it wasn't easy.

Yes, but then he goes on to suggest that it IS easier than dealing with depression. I think that while that is probably true, it is not true by much, and not true enough to make a distinction here.

As someone who has dealt with both, I personally think weight is far easier to deal with than depression, specifically because I know what to do about weight. Neither is "easy" in the absolute sense, though.

That's fair. I don't mean to judge your specific experience.

"The issue is psychological - not believing one can achieve the goal, not being ready/willing to fully commit to the goal, feeling too ashamed of oneself to believe one can improve one's situation, and on and on."

And here I was, thinking it was just that you love constantly stuffing large amounts of high-calorie foods down your throats.

Imagine how pleased I am to see you've changed that perception.

> There are safe, reliable, and well-understood ways to lose weight.

Which ways to lose weight are most safe, reliable, and effective is well-understood to actually be quite dependent on personal factors which are exactly the things that will not be properly assessed if doctors are less likely to order appropriate diagnostic tests for people that are overweight.

> They're not easy, enjoyable, or fast

They are often at least one of those (most often the last) if the appropriate method is chosen for the person, though its true that this is not always the case.

> but they're almost certain to work, excluding other medical conditions.

"Excluding other medical conditions" is exactly the problem, since comorbidities with obesity are not at all rare, and many of them are directly relevant to weight-loss strategies.

> Which ways to lose weight are most safe, reliable, and effective is well-understood to actually be quite dependent on personal factors which are exactly the things that will not be properly assessed if doctors are less likely to order appropriate diagnostic tests for people that are overweight.

Other than a few anecdotes, one of which comes from an urgent care center[1], the article provides no evidence of categorically denying diagnostic tests, only surgeries.

> "Excluding other medical conditions" is exactly the problem, since comorbidities with obesity are not at all rare, and many of them are directly relevant to weight-loss strategies.

I have yet to encounter a doctor whose response to my weight is just, "Hi! Lose weight! TTFN!" It's hard to tell with the kind of surveys presented in this article if people are really being brushed off or if they are just being told things they don't want to hear.

[1] Relevant because urgent care centers tend towards shitty experiences regardless of your weight or medical problems. Especially the ones not affiliated with a hospital system.

> Other than a few anecdotes [...] the article provides no evidence of categorically denying diagnostic tests, only surgeries.

That's not true; besides the anecdotes, there is, for example, the research review linked from the sentence noting that "Research has shown...". [0]

[0] direct link: http://onlinelibrary.wiley.com/doi/10.1111/obr.12266/full

I see a lot of discussion in that paper about stigmatization, "bedside manner" type stuff, and other things that understandably affect outcomes because it puts the doctor-patient relationship on a negative footing. I'm in complete agreement with that being a problem. However, it provides no evidence that diagnostic tests or any other care are categorically denied.

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