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Comment by keiferski | Hacker News Reader

Does this actually happen in real life, or only in online outrage anecdotes?

My guess is that doctors typically understand that the patient already knows they’re obese, and therefore tries to get them to do something, anything, that’ll help.

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Alcoholics know that they drink, chain smokers know that they smoke... Obesity has an impact on longevity that is on the same order of magnitude as cigarette smoking. I would hope that it would come up during a checkup. If it doesn't, rationalize it however you want, but it's clearly because the doc decided it wasn't worth the risk of saying it out loud. In other countries it's not uncommon to be blunt about it with friends and family, let alone at the doctor's office, but in the US it's considered extremely rude. As a result, I know many people who have a skewed definition of obesity. To them a BMI of 30 is a tad overweight and obese starts maybe at 40. They're prescribed pills and CPAP machines and no one ever tells them they need to lose weight as long as their blood work looks decent. It's easy to neglect a health issue that no one wants to talk about.

The first words out of any doctor's mouth if you're a smoker or obese is "lifestyle changes". The idea that doctor's don't talk about it is just not true.

The reality is that patients do not listen and do not have the tools to make changes. A lot of these people are barely living life, they're just on autopilot.

IME the opposite is true. I myself and several friends have had doctors that refuse to treat something until a weight issue is addressed. In my case the treatment was for obstructive sleep apnea and losing weight as part of combined therapy w my CPAP has helped a lot. In at least one friend's case she had severe, constant belly pain and multiple doctors gave her the old "have you tried losing weight about it". It wasn't until one actually engaged with her symptoms that they found out she had an active infection in her abdomen and also several tumors on her ovaries. So, you know, a mixed bag. Sometimes they tell you to lose weight because being heavy directly correlates with the symptoms you're expressing, sometimes they tell you to lose weight because losing weight is vaguely correlated with positive health impacts overall and they've got 10 minutes per patient to make a diagnosis and develop a course of treatment.

That being said, I'm gonna file "doctors are afraid to tell patients they're obese because they'll be accused of body shaming" next to "they're putting litter boxes in the classrooms so the furries can poop in front of everyone" and "strangers are putting LSD in halloween candy to get kids hooked". It's 100% made up rage bait and the people who believe it believe it because they hear it all the time from their propaganda echo chambers.

This happened to me. I switched doctors.

What happened to you? The doctor refused to diagnose you as obese, someone else, or…? Your comment is unclear.

I went to my doctor as someone overweight bordering on obese and asked for help. I told him my plan for losing weight. But, he told me I didn't need to lose weight, because being overweight isn't bad for your health. Eventually I lost 70 lbs and found a new doctor.

Interesting, but good that you did switch doctors and had success!

That is a different thing. It was not that the doctor was reluctant to recommend weight loss due to their fear of being branded as body-shaming, it was that he denied the link outright, even though you were receptive to a weight-loss plan.

Wild story, either way. I expect professionals to be better.

Being overweight isn't bad for your health, being obese is. It sounds counter-intuitive but being overweight has zero effect on your longevity or risk of cardiovascular disease. At least, not alone.

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