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Comment by ceejayoz | Hacker News Reader

I promise you, doctors have been telling fat people it's their fault for many, many decades. It's one of the most common complaints of fat people in a medical context - that the first response to nearly any medical issue is "well you should lose weight".

https://www.nbcnews.com/health/health-news/doctors-move-end-...

> When Melissa Boughton complained to her OB-GYN about dull pelvic pain, the doctor responded by asking about her diet and exercise habits.

> On this occasion, three years ago, the OB-GYN told Boughton that losing weight would likely resolve the pelvic pain. The physician brought up diet and exercise at least twice more during the appointment. The doctor said she’d order an ultrasound to put Boughton’s mind at ease. The ultrasound revealed the source of her pain: a 7-centimeter tumor filled with fluid on Boughton’s left ovary.

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A silver lining of being mentally ill is that you don't suffer from the diseases that normal people do. Doctors know whatever the complaint it's due to the mental illness.

So the doctor gave the best correct general health advice to the patient, AND did the appropriate test, and appropriately reassured the patient regarding the pre-test probability of a good vs bad outcome of the test AND followed up the rare but possible bad test finding appropriately? Would you prefer the doctor give factually incorrect advice in order to avoid upsetting a patient?

It’s interesting that you frame it as “faulting” the patient - if a patient comes in with shortness of breath, should doctors avoid asking patients if they smoke? If they ask a patient about previous surgery, are they blaming the surgeon? If a doctor asks about family or work history, are they criticizing family or work choice respectively?

That’s… certainly a way of reading this.

In this case it’s the right way of reading it.

It really isn't.

https://www.nature.com/articles/s41591-020-0803-x

> Evidence suggests that physicians spend less time in appointments and provide less education about health to patients with obesity compared with thinner patients, and patients who report having experienced weight bias in the healthcare setting have poor treatment outcomes and might be more likely to avoid future care. Obesity also adversely impacts age-appropriate cancer screening, which can lead to delays in breast, gynecological, and colorectal cancer detection.

> Negative influences on engagement with primary care were evaluated and ten themes were identified: contemptuous, patronizing, and disrespectful treatment, lack of training, ambivalence, attribution of all health issues to excess weight, assumptions about weight gain, barriers to health care utilization, expectation of differential health care treatment, low trust and poor communication, avoidance or delay of health services, and seeking medical advice from multiple HCPs.

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