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I'm disappointed by the lack of empathy in these comments. While I agree that yes, an obese person needs to lose weight, telling them that and offering no othe

I'm disappointed by the lack of empathy in these comments. While I agree that yes, an obese person needs to lose weight, telling them that and offering no other help is like telling someone with depression "why don't you just cheer up?" It's totally unuseful advice that incorporate all sorts of gross value judgments about the person. It doesn't solve problems. I've been overweight - not obese, but close at times - all my life. I'm now on a weight loss program and seeing significant success. It took years of mental and physical issues to get me to that point and it is a struggle every day. It's hard work. That's why people are proud of losing weight: it's an achievement. It represents a permanent change to lifestyle and behavior that takes weeks, months, even years to effect. Please don't discount people's experiences by saying things like "oh, just lose weight." Consider the human being in there, and how to reach them. Don't assume that because it's easy for you to be fit and skinny, it's easy for everyone.

joenot443 10y ago
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.
- ivraatiems 10y ago
  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.)
  - vonmoltke 10y ago
    > 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.
    - ivraatiems 10y ago
      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.
      - vonmoltke 10y ago
        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.
        ivraatiems 10y ago
        That's fair. I don't mean to judge your specific experience.
  - QSIITurbo 10y ago
    "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.
    - ivraatiems 10y ago
      Imagine how pleased I am to see you've changed that perception.
- dragonwriter 10y ago
  > 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.
  - vonmoltke 10y ago
    > 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.
    - dragonwriter 10y ago
      > 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 http://onlinelibrary.wiley.com/doi/10.1111/obr.12266/full
bkor 10y ago
Disagreeing with the article and agreeing with that they lose weight does NOT imply lacking empathy. Then entire article states some ridiculous claims. If you're obese, it is a danger to your health. If go then go to a doctor what do you expect the doctor to do? Ignore this because the person might not want to hear it? You're rephrasing things with "just lose weight": nobody said it is easy to lose weight. But if you're obese, you're in the danger zone.
- deleted 10y ago
  [deleted]
- ivraatiems 10y ago
  This isn't about what I'd expect a doctor to do. Of course I'd expect a doctor to say "lose weight." What I am taking issue with is the way commenters here are treating that imperative, "lose weight," as though it is some very simple thing for severely obese people. It isn't.
- dragonwriter 10y ago
  > Disagreeing with the article and agreeing with that they lose weight does NOT imply lacking empathy. That's true. Dismissing the studies cited in the article clearly showing that doctors do give inferior care (particularly, in being less willing to refer for medically-appropriate diagnostic tests) to obese people (which, incidentally, inhibits their ability to give useful direction to those people on how to safely and effectively lose weight) goes beyond mere lack of empathy the whole way to willful ignorance and active hostility.
jakebasile 10y ago
It's infuriating. HN commenters will fall over themselves to rail against discrimination, real or imagined, against women and minorities, but it's perfectly OK to insult, demean, and minimize the problems of big people. They know nothing about their lives, why they are big, what their health problems come from, what they've tried to lose weight. It's easy to dismiss them as weak willed disgusting blobs of fat, ignoring the human being underneath that is trying to live their life as best they can.
- ivraatiems 10y ago
  In fairness to HN, this is a societal problem, not an HN problem. It's a viewpoint issue that affects lots of people.
  - jakebasile 10y ago
    That's true. I think I'm just especially aghast at the comments here because I generally enjoy this community and figured there would be more empathy.
- dragonwriter 10y ago
  > It's infuriating. HN commenters will fall over themselves to rail against discrimination, real or imagined, against women and minorities, but it's perfectly OK to insult, demean, and minimize the problems of big people. I don't think that's true at all. The people that are most described by the latter are also, often, the HN posters most opposed to the former. THere's, obviously, some differences here, but not to the extent of your description.
  - jakebasile 10y ago
    My issue is that if comments like this happened on an article about another class of people, it simply wouldn't be acceptable here. Imagine an article about African American men getting poorer care for heart disease because they are more susceptible to it, and the comments claiming that it's perfectly reasonable and they should just exercise more to compensate for it.
echlebek 10y ago
I don't think the message is "just lose weight". It's "before we can treat this knee problem, we need to deal with your weight problem". Being obese is a critical health problem. It's not wrong for doctors to prioritize it, and I don't think it belies a lack of empathy to agree with them. I say this as a person with a weight control problem.
- Avshalom 10y ago
  "Before we fix your knee we're gonna need you to start running more"
shortformblog 10y ago
This is pretty much how I felt when I read these comments. The argument being made by the piece is that weight is treated as a binary issue, without nuance. Yes, the problem is there—it's apparent, they see it right in front of them, thanks for noticing—but that doesn't mean that other issues should be looked over in diagnosis. Some doctor choosing not to even consider a patient's medical problem without looking past a single issue—especially when that patient is actually seeing some success in dealing with that issue on their own, as seen in the Patty Nece example highlighted by the Times—is a waste of everyone's time. From a purely economic perspective, a patient who is paying thousands of dollars for insurance and not-insignificant copays is not getting what they paid for if the doctor treats their patients in this way. Yes, weight loss solves a lot of problems, but the complication of losing weight for the myriad metabolism types out there makes the solution a challenging one for many types of people. For all the doctors know, their patients could be walking five miles a day and eating a 1,500-calorie vegan diet, but finding their success rate doesn't match the amount of work they're putting in. Their weight may yo-yo in a dramatic way that can make sustaining a healthy weight very challenging. Weight loss is not like aspirin. It doesn't work exactly the same for everyone. (And there are bad ways of losing weight, of course.) This Times article from May, while it obviously highlights extreme cases (Biggest Loser contestants), is worth bringing up in the context of this conversation: http://www.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html http://www.nytimes.com/2016/05/02/health/biggest-loser-weigh... Obesity is a hard problem to solve as a society. To solve that problem, we have to consider the issue thoughtfully, from all sides.
forgottenpass 10y ago
Don't assume that because it's easy for you to be fit and skinny, it's easy for everyone. I'm neither fit nor skinny. I am empathetic, what I am NOT is sympathetic. I have a problem, and I need to fix it. I'm working on it. But even when I'm not, I understand that my health problems are and will be primarily weight related. I actually sort of resent the comparison between "why don't you just cheer up?" and "oh, just lose weight." Everyone understands that weight loss is diet and exercise, even if they've never have to do it. Most people don't understand that depression isn't just an extra long bit of being bummed out, let alone know what the resources a person might need to overcome depression are or how much more complicated it can be. Sure, they both have an initial inertia that needs to be overcome to get started on fixing it, but I'm much more sympathetic to the depressed.
- ivraatiems 10y ago
  > I actually sort of resent the comparison between "why don't you just cheer up?" and "oh, just lose weight." Everyone understands that weight loss is diet and exercise, even if they've never have to do it. Most people don't understand that depression isn't just an extra long bit of being bummed out, let alone the resources a person might need to overcome depression. > I am empathetic, what I am NOT is sympathetic. I have a problem, and I need to fix it. That's a healthy outlook for you to have. It's the one I have, too. The people we need to have sympathy/empathy for, though, are the people who haven't gotten there yet. I imagine there was a time for you where you hadn't reached the point of understanding your problem, for any of the various reasons of shame, denial, anger, blaming others, etc. There are a lot of people in that boat. What I think commenters here don't understand isn't that weight loss is relatively straightforward, it's that straightforward things aren't always easy, and that preparing oneself to do something difficult is hard, even if that difficult thing has clear steps to take. Given that other people have pointed out the same vagueness in my comparison to depression, maybe it wasn't the best one to make. I will think on a different one for next time. I do think that, given the above, it makes my point though.
  - forgottenpass 10y ago
    The people we need to have sympathy/empathy for, though, are the people who haven't gotten there yet. Why though? Isn't sympathy towards people who "haven't gotten there yet" really fucking patronizing? I'm not on this "empathy" bandwagon that has gotten popular in the last few years. It's really good at being unemphatic towards people the group has already decided not to like, so the whole thing reads as a sham. I imagine there was a time for you where you hadn't reached the point of understanding your problem, for any of the various reasons of shame, denial, anger, blaming others, etc. They're adults. I'll treat them with the civility I treat everyone. Beyond that? Fuck 'em.
deleted 10y ago
[deleted]

joenot443 10y ago

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.

ivraatiems 10y ago
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.)
- vonmoltke 10y ago
  > 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.
  - ivraatiems 10y ago
    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.
    - vonmoltke 10y ago
      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.
      - ivraatiems 10y ago
        That's fair. I don't mean to judge your specific experience.
- QSIITurbo 10y ago
  "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.
  - ivraatiems 10y ago
    Imagine how pleased I am to see you've changed that perception.
dragonwriter 10y ago
> 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.
- vonmoltke 10y ago
  > 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.
  - dragonwriter 10y ago
    > 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 http://onlinelibrary.wiley.com/doi/10.1111/obr.12266/full

bkor 10y ago

Disagreeing with the article and agreeing with that they lose weight does NOT imply lacking empathy. Then entire article states some ridiculous claims. If you're obese, it is a danger to your health. If go then go to a doctor what do you expect the doctor to do? Ignore this because the person might not want to hear it? You're rephrasing things with "just lose weight": nobody said it is easy to lose weight. But if you're obese, you're in the danger zone.

deleted 10y ago
[deleted]
ivraatiems 10y ago
This isn't about what I'd expect a doctor to do. Of course I'd expect a doctor to say "lose weight." What I am taking issue with is the way commenters here are treating that imperative, "lose weight," as though it is some very simple thing for severely obese people. It isn't.
dragonwriter 10y ago
> Disagreeing with the article and agreeing with that they lose weight does NOT imply lacking empathy. That's true. Dismissing the studies cited in the article clearly showing that doctors do give inferior care (particularly, in being less willing to refer for medically-appropriate diagnostic tests) to obese people (which, incidentally, inhibits their ability to give useful direction to those people on how to safely and effectively lose weight) goes beyond mere lack of empathy the whole way to willful ignorance and active hostility.

jakebasile 10y ago

It's infuriating. HN commenters will fall over themselves to rail against discrimination, real or imagined, against women and minorities, but it's perfectly OK to insult, demean, and minimize the problems of big people. They know nothing about their lives, why they are big, what their health problems come from, what they've tried to lose weight. It's easy to dismiss them as weak willed disgusting blobs of fat, ignoring the human being underneath that is trying to live their life as best they can.

ivraatiems 10y ago
In fairness to HN, this is a societal problem, not an HN problem. It's a viewpoint issue that affects lots of people.
- jakebasile 10y ago
  That's true. I think I'm just especially aghast at the comments here because I generally enjoy this community and figured there would be more empathy.
dragonwriter 10y ago
> It's infuriating. HN commenters will fall over themselves to rail against discrimination, real or imagined, against women and minorities, but it's perfectly OK to insult, demean, and minimize the problems of big people. I don't think that's true at all. The people that are most described by the latter are also, often, the HN posters most opposed to the former. THere's, obviously, some differences here, but not to the extent of your description.
- jakebasile 10y ago
  My issue is that if comments like this happened on an article about another class of people, it simply wouldn't be acceptable here. Imagine an article about African American men getting poorer care for heart disease because they are more susceptible to it, and the comments claiming that it's perfectly reasonable and they should just exercise more to compensate for it.

echlebek 10y ago

I don't think the message is "just lose weight". It's "before we can treat this knee problem, we need to deal with your weight problem". Being obese is a critical health problem. It's not wrong for doctors to prioritize it, and I don't think it belies a lack of empathy to agree with them. I say this as a person with a weight control problem.

Avshalom 10y ago
"Before we fix your knee we're gonna need you to start running more"

shortformblog 10y ago

This is pretty much how I felt when I read these comments. The argument being made by the piece is that weight is treated as a binary issue, without nuance. Yes, the problem is there—it's apparent, they see it right in front of them, thanks for noticing—but that doesn't mean that other issues should be looked over in diagnosis. Some doctor choosing not to even consider a patient's medical problem without looking past a single issue—especially when that patient is actually seeing some success in dealing with that issue on their own, as seen in the Patty Nece example highlighted by the Times—is a waste of everyone's time. From a purely economic perspective, a patient who is paying thousands of dollars for insurance and not-insignificant copays is not getting what they paid for if the doctor treats their patients in this way. Yes, weight loss solves a lot of problems, but the complication of losing weight for the myriad metabolism types out there makes the solution a challenging one for many types of people. For all the doctors know, their patients could be walking five miles a day and eating a 1,500-calorie vegan diet, but finding their success rate doesn't match the amount of work they're putting in. Their weight may yo-yo in a dramatic way that can make sustaining a healthy weight very challenging. Weight loss is not like aspirin. It doesn't work exactly the same for everyone. (And there are bad ways of losing weight, of course.) This Times article from May, while it obviously highlights extreme cases (Biggest Loser contestants), is worth bringing up in the context of this conversation: http://www.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html http://www.nytimes.com/2016/05/02/health/biggest-loser-weigh... Obesity is a hard problem to solve as a society. To solve that problem, we have to consider the issue thoughtfully, from all sides.

forgottenpass 10y ago

Don't assume that because it's easy for you to be fit and skinny, it's easy for everyone. I'm neither fit nor skinny. I am empathetic, what I am NOT is sympathetic. I have a problem, and I need to fix it. I'm working on it. But even when I'm not, I understand that my health problems are and will be primarily weight related. I actually sort of resent the comparison between "why don't you just cheer up?" and "oh, just lose weight." Everyone understands that weight loss is diet and exercise, even if they've never have to do it. Most people don't understand that depression isn't just an extra long bit of being bummed out, let alone know what the resources a person might need to overcome depression are or how much more complicated it can be. Sure, they both have an initial inertia that needs to be overcome to get started on fixing it, but I'm much more sympathetic to the depressed.

ivraatiems 10y ago
> I actually sort of resent the comparison between "why don't you just cheer up?" and "oh, just lose weight." Everyone understands that weight loss is diet and exercise, even if they've never have to do it. Most people don't understand that depression isn't just an extra long bit of being bummed out, let alone the resources a person might need to overcome depression. > I am empathetic, what I am NOT is sympathetic. I have a problem, and I need to fix it. That's a healthy outlook for you to have. It's the one I have, too. The people we need to have sympathy/empathy for, though, are the people who haven't gotten there yet. I imagine there was a time for you where you hadn't reached the point of understanding your problem, for any of the various reasons of shame, denial, anger, blaming others, etc. There are a lot of people in that boat. What I think commenters here don't understand isn't that weight loss is relatively straightforward, it's that straightforward things aren't always easy, and that preparing oneself to do something difficult is hard, even if that difficult thing has clear steps to take. Given that other people have pointed out the same vagueness in my comparison to depression, maybe it wasn't the best one to make. I will think on a different one for next time. I do think that, given the above, it makes my point though.
- forgottenpass 10y ago
  The people we need to have sympathy/empathy for, though, are the people who haven't gotten there yet. Why though? Isn't sympathy towards people who "haven't gotten there yet" really fucking patronizing? I'm not on this "empathy" bandwagon that has gotten popular in the last few years. It's really good at being unemphatic towards people the group has already decided not to like, so the whole thing reads as a sham. I imagine there was a time for you where you hadn't reached the point of understanding your problem, for any of the various reasons of shame, denial, anger, blaming others, etc. They're adults. I'll treat them with the civility I treat everyone. Beyond that? Fuck 'em.

deleted 10y ago

[deleted]