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Comment by newfeatureok | Hacker News Reader

Would you really want a doctor who is obese? A mildly overweight doctor, sure. But obese?

The reality is, if you have a list of doctors and their pictures and know nothing of them except for their appearance I highly doubt anyone would pick the obese person as their first pick.

It’s just reality. Someone capable of going through medical school is capable of reducing their weight to being merely overweight as opposed to obese.

People going on “yeah if they know their stuff” are missing the point. You don’t know if they know their stuff at all.

As for unattractive, yes that’s bad.

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Honestly as long as they know their "stuff" I don't really care at all about the appearance of a Doctor(or if they smoke etc). There are a multitude of reasons a person could be obese (genetics, digestive disorders/longer intestines). Also people have choices, if a Dr. tells me smoking is bad and he smokes he is choosing to do so despite evidence that its dangerous. I respect the ability for individuals to make choices, even if I don't agree with them.

For me, seeing a grossly unhealthy doctor -- be it obesity or a drug addiction like smoking -- wouldn't exactly instill confidence.

So you prefer doctors with flaws you can't see.

> appearance of a Doctor(or if they smoke etc).

Being fat is different to smoking.

To get high from smoking you must smoke. To love food you don't have to be fat.

Being an alcoholic is more comparable. Or a two pack a day smoker.

A doctor should be vaping though. If they don't vape that is bad. But I feel like these things are small compared to all the other problems we have with doctors, like overwork.

I don't know. It's like having a car mechanic with a broken down car, or an IT professional with a Yahoo! toolbar.

one of Nassim Taleb's better ideas is that you should pick the worst-looking doctor you can find -- weird-looking, fat, lower-class accent, whatever -- because if they're successfully practicing medicine, they must be very skilled to make up for the unfair judgments throughout med school interviews, residency, and fellowships.

Or they're just on the verge of a stroke or severely under-slept while deciding where in your skull to drill. Yeah I think I'm cool with the somewhat healthy doc.

That's the first idea from Tabeb I've ever heard that makes sense.

I had to fact check and he did say it -

https://medium.com/incerto/surgeons-should-notlook-like-surg...

Where do you get to choose a doctor? I have a "primary care doctor" but if I had to choose another one, it would be an arduous process. And I have to pay a large premium to visit her rather than just going to urgent care. So for most situations, I effectively get whatever doctor is on shift when I go to the clinic.

Realistically, adding any non essential criteria to my search would narrow my choices down to possibly a very small number.

...lived in several European countries, and have friends/ family in others (also two siblings in USA) - always been able to choose my doctor(s).

I’ve always chosen my doctor in the US. I’ve always had HDHP PPO health insurance. Even if you don’t have health insurance, you can call any office and make an appointment unless they’re a specialist requiring referral.

Many parents even interview pediatricians before choosing who to go with.

I would not want an obese nutritionist. I don't care about an obese neurologist. Context matters.

I think he's referring to a General Practitioner who IMO should really practice what the preaches. If doctor is unhealthy it doesn't exactly instill confidence.

You're saying that like being obese is has a trivial fix people just don't want to apply. I'd totally see a doctor who is obese. Or a doctor who smokes. Or many others. In terms of dealing with obesity they may actually have more insight and know more resources than people not affected by this issue.

There's a big difference between behaviours applied to self and knowledge applied at work.

The fix to obesity is caloric restriction. As an extreme example, look at pictures of people in concentration camps: no obese people there. The reason why it’s a good example is because it’s “forced” caloric restriction, and it shows that it works. Obese people make the choice to consume more calories than requires, hence being obese.

Sure, but that doesn't make it a trivial fix. Unless you figured out how to influence ingrained behaviours / addictions better than any existing methods? This comment is like "the fix to smoking is to not smoke" - yes everybody knows that. Actually applying that across population is the hard part.

The point still needs to be made, since there are _still_ people who honestly believe that weight loss is achieved by some mechanism other than consuming less calories than is expended. They still think there is some other form of "magic" involved. So to digress the discussion onto behaviours, etc. is a distraction from the fundamental fact that needs to be hammered home until it becomes ingrained. At that point we can work on the behaviours required to achieve that end. Otherwise you have what you have now, people changing behaviours and trying to eat healthy, or exercise more, thinking that those behaviours are the magic secret to weight loss. It is not, and you can lose weight eating McDonalds and sitting at your desk all day if the amount of calories in the McDonalds you're eating is low enough. It's not healthy, but healthy/not healthy has nothing to do with calorie restriction and consequently weight loss.

There's still a massive difference between eating food that's digested over a long time and eating candy with the same calories. It impacts the whole process and how much people will realistically restrict themselves. There's issues with body image where people don't realise they're actually obese. There's comfort food related to life stress. And so many other issues. Sure, calorie restriction is an important piece of the puzzle, but saying the rest is a distraction is a really shallow understanding of the problem. It's like that "how to draw an owl" meme - true, but the instruction are so simple they're useless.

The type of food you eat impacts how many calories you will actually end up eating.

Would you really want a doctor who is obese? A mildly overweight doctor, sure. But obese?

I think it would depend on the specialty. I wouldn't really care if my radiologist is obese. He can read and interpret my scans just fine. Same for pathology, endo and renal docs. I don't think I'd want an obese ER doc as CPR is pretty tiring, same with my anesthesiologist- don't want them sweaty and out of breath while trying to put in an airway.

I don't give half a shit about the physical appearance of my doctors - what could it possibly say about their competence as a doctor?

I dunno.

Maybe he's so skilled that his employers (e.g. hospital) disregarded his appearance?

Or perhaps you were thinking if he's sloppy with his appearance, he'll be sloppy providing care.

Would you care if your personal trainer was obese?

That would performance - if we're going for a run, how are they going to keep up and last the distance?

As another example, it's not unusual for top-level sports coaches (e.g. soccer, tennis) to be older, and to be overweight - it's their past experience that is useful, not their current appearance.

I'd be curious for a study looking at whether obese nutritionists would be more or less effective than fit ones. People tend to trust people more like them, and I can definitely imagine a dynamic where an obese person would resent a skinny doctor telling them how to improve their diet. And, since obese people are in the most need of nutritional advice, perhaps getting more obese representation into the ranks of doctors would do some good.

Or maybe doctors should just wear fat suits.

Unfortunately with the rise of the Fat Activist movement, many nutritionists now pander to clients by advocating eating practices that are unhealthy and dangerous.

Harm reduction is the name of the game. It's far better to get 50% of the obese to move to the highly overweight category than it is to get 10% to the normal category. I wouldn't be surprised (though I'd want to see evidence) that offering less severe and more achievable advice is more effective as a population-level strategy.

My last endodontist thoroughly explained everything, made a root canal as comfortable as possible and saved me a bit of money.

He also had bad teeth.

Obesity carries no signal about their competence as a doctor, so yes.

I wouldn't say no signal at all. If I have data that they are the best doctor from my options and are obese, yeah totally, I'll go for them. But if I just see a lineup of doctors and all else is equal, I'm definitely picking the obese one last.

It's possible that they're obese due to some condition relatively out of their control, or that they're working on it, (and my answer applies specifically to the US) but when 40% of the US is obese, it more than likely reflects on them as a person and their values.

I wouldn't. Just as I wouldn't want a doctor who is a heroin addict.

Being obese doesn't make you incapable of doing your job.

There are also high-functioning drug addicts. Nevertheless I probably wouldn't want one for a doctor.

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