3 ms·

As a person who has been told I'm "morbidly obese" for decades now, I will say that doctors at almost every level look at your chart not you. I've been told tim

As a person who has been told I'm "morbidly obese" for decades now, I will say that doctors at almost every level look at your chart not you. I've been told time and time again that until I get my weight under control, my health will suffer. I'm 5'8" and weigh on average 210lbs. My BMI isn't even morbidly obese, it is 31, which is just "regular" obese, but on top of that, a DEXA scan shows that I am actually only 25% body fat, with only 1lb of visceral fat. Doctor's don't care about that, they see on the Epic chart that my BMI is > 30 and have to tell me some spiel about a healthier lifestyle so they check check off a checkbox and continue to the next screen.

prmoustache 9mo ago
> Doctor's don't care about that Literally all of them?
- jermaustin1 9mo ago
  I can't say literally all, but in my experience with having to get a new GP almost every year because of health insurance changes, location changes, hospital consolidation buying my GPs practice, and multiple doctors retiring or just quitting medicine (my last GP was tired of medicine after practicing for only 3 years). Over the last 20 years, I've had almost 15 GPs across 5 states (NY, NJ, CT, TX, LA). I also have multiple auto immune diseases, so I have had a handful of specialists of various flavors (endocrine, oncology - not for cancer, cardiology, and urology), but only need them occasionally. Almost every single start of every single appointment (including a follow up from just a couple days prior), they comment about my BMI. It is the rare time they don't that I remember. My last urology appointment the doctor was very congenial, didn't even go over the lab work, just said, everything is looking good, asked how I was feeling, everything good, alright, refilled my prescriptions and left.
- coldtea 9mo ago
  When humans talk, they use generalizations (and don't need to annouce them). Here it means that most doctors don't care about that. Follow that rule next time you read such a statement in a context that's not formal math.
  - prmoustache 9mo ago
    > most That is not even true. We are talking anecdotal evidence here.
    - coldtea 9mo ago
      Yes, humans have found that you don't need officially stamped statistics (and in many cases they're unreliable or "doctored" anyway), and that they can make general observations on their own, through something they call experience. And a near universal experience with doctors for anybody paying attention is that. One can reject it or accept it and improve upon it after checking its predictive power, or they can pause their thinking and wait for some authority to give them the official numbers on that.
  - PaulDavisThe1st 9mo ago
    > When humans talk, they use generalizations All humans? Sorry :)
    - coldtea 9mo ago
      Well, when humans talk, they use generalizations, which applies recursively to this statement :) Though, on second thought: yes, all humans, and not merely as a generalization. 100% of humans do it.
Nicook 9mo ago
I mean those stats arent good...
joshhart 9mo ago
Huh. The standard in your case is to measure waist circumference if BMI is high. Did no doctor do that? As long as you are below 40” or 37” if Asian you are considered good to go.
- jermaustin1 9mo ago
  None ever did. On top of that, I'm not sure if that is a real indication of anything, either. The reason to do that is to get an idea of your abdominal fat (which is the more dangerous place for fat to store), but there are two types of abdominal fat, one is dangerous (visceral fat) and one is completely benign (subcutaneous fat). And a measurement around your waist won't tell you which you have. I personally have almost all of my fat subcutaneous, with only 1lb of visceral fat (which is right in the perfect range).
sotix 9mo ago
I'd consider 5'8 and 210lbs morbidly obese. An average male at 5'8 should generally weigh about 150lbs and no more than 164lbs.
- Teever 9mo ago
  Or that guy could be a burly bricklacker / concerete worker who can casually carry hundreds of pounds of weight all day every day in brutal conditions. It's really hard to tell with the data provided.
  - jermaustin1 9mo ago
    burly - maybe, but I haven't done any hard labor most of my life. I ran track as a kid, and kept my high metabolism - (RMR: 2460kcal, TDEE: 3380kcal); well lost it when my thyroid failed, but medicated myself back to it. I eat what I want, but its a very high lean-meat diet (lots of chicken breast and turkey because my wife likes them), but I don't limit my carb intake either, as I mostly burn sugar for energy (according to my Respiratory Exchange Ratio). Somehow my body is just amazing at working without any help from me. I don't even exercise much. Maybe a few pushups a day, up and down my stairs at my house a couple dozen times a day, and probably 5-10k steps a day max.
- jermaustin1 9mo ago
  If I got rid of all of my fat and bones, I'd still weigh more than 150lbs. I have the most muscular 150lbs man inside of me. Ideal body fat percentage is 18-24% - I'm at 25% (or was in November - might be +/- 2% since then - gained a few pounds weight, but not waist size). So I would say I'm not morbidly obese or even regular obese based on the percentage of my body that is muscle vs fat.
  - machomaster 9mo ago
    You are fat, though. For a man, the ideal fat percentage is 15-20%. 20+%, let alone 25%, is not healthy at all.
- csa 9mo ago

prmoustache 9mo ago

> Doctor's don't care about that Literally all of them?

jermaustin1 9mo ago
I can't say literally all, but in my experience with having to get a new GP almost every year because of health insurance changes, location changes, hospital consolidation buying my GPs practice, and multiple doctors retiring or just quitting medicine (my last GP was tired of medicine after practicing for only 3 years). Over the last 20 years, I've had almost 15 GPs across 5 states (NY, NJ, CT, TX, LA). I also have multiple auto immune diseases, so I have had a handful of specialists of various flavors (endocrine, oncology - not for cancer, cardiology, and urology), but only need them occasionally. Almost every single start of every single appointment (including a follow up from just a couple days prior), they comment about my BMI. It is the rare time they don't that I remember. My last urology appointment the doctor was very congenial, didn't even go over the lab work, just said, everything is looking good, asked how I was feeling, everything good, alright, refilled my prescriptions and left.
coldtea 9mo ago
When humans talk, they use generalizations (and don't need to annouce them). Here it means that most doctors don't care about that. Follow that rule next time you read such a statement in a context that's not formal math.
- prmoustache 9mo ago
  > most That is not even true. We are talking anecdotal evidence here.
  - coldtea 9mo ago
    Yes, humans have found that you don't need officially stamped statistics (and in many cases they're unreliable or "doctored" anyway), and that they can make general observations on their own, through something they call experience. And a near universal experience with doctors for anybody paying attention is that. One can reject it or accept it and improve upon it after checking its predictive power, or they can pause their thinking and wait for some authority to give them the official numbers on that.
- PaulDavisThe1st 9mo ago
  > When humans talk, they use generalizations All humans? Sorry :)
  - coldtea 9mo ago
    Well, when humans talk, they use generalizations, which applies recursively to this statement :) Though, on second thought: yes, all humans, and not merely as a generalization. 100% of humans do it.

Nicook 9mo ago

I mean those stats arent good...

joshhart 9mo ago

Huh. The standard in your case is to measure waist circumference if BMI is high. Did no doctor do that? As long as you are below 40” or 37” if Asian you are considered good to go.

jermaustin1 9mo ago
None ever did. On top of that, I'm not sure if that is a real indication of anything, either. The reason to do that is to get an idea of your abdominal fat (which is the more dangerous place for fat to store), but there are two types of abdominal fat, one is dangerous (visceral fat) and one is completely benign (subcutaneous fat). And a measurement around your waist won't tell you which you have. I personally have almost all of my fat subcutaneous, with only 1lb of visceral fat (which is right in the perfect range).

sotix 9mo ago

I'd consider 5'8 and 210lbs morbidly obese. An average male at 5'8 should generally weigh about 150lbs and no more than 164lbs.

Teever 9mo ago
Or that guy could be a burly bricklacker / concerete worker who can casually carry hundreds of pounds of weight all day every day in brutal conditions. It's really hard to tell with the data provided.
- jermaustin1 9mo ago
  burly - maybe, but I haven't done any hard labor most of my life. I ran track as a kid, and kept my high metabolism - (RMR: 2460kcal, TDEE: 3380kcal); well lost it when my thyroid failed, but medicated myself back to it. I eat what I want, but its a very high lean-meat diet (lots of chicken breast and turkey because my wife likes them), but I don't limit my carb intake either, as I mostly burn sugar for energy (according to my Respiratory Exchange Ratio). Somehow my body is just amazing at working without any help from me. I don't even exercise much. Maybe a few pushups a day, up and down my stairs at my house a couple dozen times a day, and probably 5-10k steps a day max.
jermaustin1 9mo ago
If I got rid of all of my fat and bones, I'd still weigh more than 150lbs. I have the most muscular 150lbs man inside of me. Ideal body fat percentage is 18-24% - I'm at 25% (or was in November - might be +/- 2% since then - gained a few pounds weight, but not waist size). So I would say I'm not morbidly obese or even regular obese based on the percentage of my body that is muscle vs fat.
- machomaster 9mo ago
  You are fat, though. For a man, the ideal fat percentage is 15-20%. 20+%, let alone 25%, is not healthy at all.
csa 9mo ago