Doctors say obesity isn't a disability

morningstar

Cathlete
Actually, what I think labeling addiction a disease does is disempowers the addict- after all, if something is a disease, then they have no control over it, and therefore might as well give up, right?
 

hiitdogs

Cathlete
Actually, what I think labeling addiction a disease does is disempowers the addict- after all, if something is a disease, then they have no control over it, and therefore might as well give up, right?

Really? So the people who have cancer or heart disease might as well just give up because they have a "disease"? Can't do anything about it? Can't control it? Doesn't that disempower those people too?

Sorry but I disagree with that!
 

marnapril

Cathlete
Actually, what I think labeling addiction a disease does is disempowers the addict- after all, if something is a disease, then they have no control over it, and therefore might as well give up, right?

you have control over a disease. whether it's the treatment you seek, the method you use to control symptoms, the way you deal with it mentally, who you talk to... you have control on one level or another. i do not think labelling addiction disempowers anyone.

now, treating addiction as a moral failure, as a weakness, or something to be dealt with in the criminal justice system.. THESE disempower the addict.
 

icumom

Cathlete
My dad,a Notre Dame,Wharton school graduate,exec on Wall St.Married to Miss NY(my mom),had me,smart and pretty kid - big house on the shore...we were perfect.....no one knew the lonely sad household I lived in due to Dad's alcoholism.Mom split w/ me when I was 11,and we lived in a 1br apt from then on..and never regretted it...by the time I was 16,my dad hit bottom,pushed his car from a ditch which he took as a metaphor for life...never touched a drop again,married my stepmom,adopted her 2 girls,and 30 years later all of us have graduate degrees, stable marriages,and the grandkids have a Pop who is active,vigorous,full of stories,learning, reams of books, and no clue to the nightmare of life with an alcoholic...
Forgiveness aside, the more beautiful word is Redemption...buying oneself back to life.

My point - Dad says, with all his education and learning that the booze is a genetic thing, he can control all, but one drink and the compulsion takes over....he believes, and it makes sense that it is TRULY a disorder- likely genetic and involves metabolism,tolerance of the drug, etc....BUT, it is a choice to pick up the first drink or not...THAT is the power.....

And self esteem......he was full of self loathing until he did the ultimate HARD thing and quit drinking....then self esteem was earned....and his life redeemed.....

Obesity - can't swear off food...that's a problem....
 
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Aquajock

Cathlete
My dad,a Notre Dame,Wharton school graduate,exec on Wall St.Married to Miss NY(my mom),had me,smart and pretty kid - big house on the shore...we were perfect.....no one knew the lonely sad household I lived in due to Dad's alcoholism.Mom split w/ me when I was 11,and we lived in a 1br apt from then on..and never regretted it...by the time I was 16,my dad hit bottom,pushed his car from a ditch which he took as a metaphor for life...never touched a drop again,married my stepmom,adopted her 2 girls,and 30 years later all of us have graduate degrees, stable marriages,and the grandkids have a Pop who is active,vigorous,full of stories,learning, reams of books, and no clue to the nightmare of life with an alcoholic...
Forgiveness aside, the more beautiful word is Redemption...buying oneself back to life.

My point - Dad says, with all his education and learning that the booze is a genetic thing, he can control all, but one drink and the compulsion takes over....he believes, and it makes sense that it is TRULY a disorder- likely genetic and involves metabolism,tolerance of the drug, etc....BUT, it is a choice to pick up the first drink or not...THAT is the power.....

And self esteem......he was full of self loathing until he did the ultimate HARD thing and quit drinking....then self esteem was earned....and his life redeemed.....

Obesity - can't swear off food...that's a problem....

ICUMom, thank you for posting such a moving story. I could relate to much of your father's experience: came from a well-educated household, had good post-secondary education myself, had seen first-hand the destructive nature of alcoholic drinking in my own family . . . and all that knowledge couldn't change the fact that I too was / am an alcoholic. Alcohol gripped me in a way that it never seemed to grip most others I knew, and that one first drink created an insatiable desire for the next and the next and the next.

Thankfully, I was able by some miracle to make a quiet decision almost 22 years ago, a decision I was then to make each day again. My life then and now has been like night to day, just like my personality was like night to day drunk versus sober.

There are certainly those who would argue that alcoholism doesn't exist at all, and if it does (which is admitted to only grudgingly) that it isn't a "disease". While I'm a bit fuzzy on the actual clinical, medical definition of "disease", I am here to state out loud that there is a significant minority of people who are genetically incapable of processing alcohol safely. It will always be a dangerous substance to them - and me - and the danger only increases as one ages. Those who wish to dispute that might need to take a look at why they don't want to believe something as much "fun" as booze can be so dangerous . . . or perhaps look at themselves.

Anyway. ICUMom, thanks again. That was a brave self-revelation.

A-Jock
 
OK, I'll bite! As someone classified as "obese" according to the BMI chart (or am I just overweight now?), I agree with the decision but not the reason. I don't think obesity should be considered a disability. MOST (but by no means all) people who are obese got that way because of poor choices. Most (again, by no means all) people who are truly disabled (i.e. blind, deaf, in a wheelchair, etc.) did not make choices that resulted in their disability. I don't understand why they feel it would open them up to lawsuits to discuss the patients weight. If they do it compassionately, I don't see the problem. Just like most overweight people, I realize I am overweight. I don't feel discriminated against if my physician mentions it. I would probably feel she wasn't doing her job if she DIDN'T mention it!

Carrie
Well said Carrie! Julie
 

kathryn

Cathlete
I agree with the AMA and carress1973: obesity is not a disability.
I agree as well (though in some rare cases---like maybe 2%-5% of the population--obesity may be considered a disability because it is linked to a specific genetic problem.)
 

Davidj

Cathlete
Convincing an obese friend to change his ways

I appreciate the thoughts on this thread. I still agree with the AMA on this one, and that people have to make a brave choice to change their lives. Since I have been thin all of my life, and abstain from drinking, I probably have trouble understanding the difficulties other people have. And babindy, I congratulate you for pursuing your strong food and exercize program.

I fully agree with Aquajock, that one has to make a singularly stark decision, at a point in life, to change oneself. And Aquajock, I admire your lifestyle change.

Since this thread has continued on, I will describe my obese friend, asking for suggestions and encouragement (to me), to try to reform him. Let's call him "Brian". My church pastor and I mentor him. Brian is 34 years old, big-boned, 5'10" and 340 lbs (with a huge belly). He is on welfare, and is trying to finish his last exam to attain adult high-school equivalency. He makes a small income supplement to welfare, cleaning my house for three hours a week. He shares custody of a 7-year-old boy. He tried two in-class university courses (I paid the tuition), but earned a D and and F in them. He wants to take some university extension courses this fall.

Brian has high blood pressure and suffers from stress. He takes a blood-thinning medication for his high blood pressure. Doctors services are free in Canada, but he does not visit his doctor for check-ups. He eats terribly, mostly fatty or carbohydrate food, sugary cola, potato chips, etc. I buy about $25 worth of fruits and vegetables for him each week, but have no way of monitoring him as to whether or not he eats the food. In February, while walking into our church in the everning, he had a heart attack scare, with the fire department and ambulence taking him away to the hospital.

I offered to give him my heavier barbell and weights (since I am replacing some of the metal dumbells with vinyl weights) -- suggesting that he take up weightlifting. Yet he makes excuses not wanting to take the weights ("no room in my apartment"). He makes similar excuses as to not wanting to change his diet (and I realize high-calorie food is "cheap", such that the poor tend to load up on junk food).

Anyways, at this stage my pastor wants him to take a an evening course, a course that teaches overweight people how to lose weight (I will find the name of the course and fly it by readers in a day or so). The course costs $350 and I offered to pay for the course. This is where we are at the moment.

So it is difficult mentoring Brian. His case, I think, is one where a deternined lifestyle change could help him. Any suggestions from people would be helpful. On the rare times we walk together, he huffs and puffs, and I have to slow down to allow him to keep up with me. And I am 60 years old.
--David
 

Aquajock

Cathlete
I appreciate the thoughts on this thread. I still agree with the AMA on this one, and that people have to make a brave choice to change their lives. Since I have been thin all of my life, and abstain from drinking, I probably have trouble understanding the difficulties other people have. And babindy, I congratulate you for pursuing your strong food and exercize program.

I fully agree with Aquajock, that one has to make a singularly stark decision, at a point in life, to change oneself. And Aquajock, I admire your lifestyle change.

Since this thread has continued on, I will describe my obese friend, asking for suggestions and encouragement (to me), to try to reform him. Let's call him "Brian". My church pastor and I mentor him. Brian is 34 years old, big-boned, 5'10" and 340 lbs (with a huge belly). He is on welfare, and is trying to finish his last exam to attain adult high-school equivalency. He makes a small income supplement to welfare, cleaning my house for three hours a week. He shares custody of a 7-year-old boy. He tried two in-class university courses (I paid the tuition), but earned a D and and F in them. He wants to take some university extension courses this fall.

Brian has high blood pressure and suffers from stress. He takes a blood-thinning medication for his high blood pressure. Doctors services are free in Canada, but he does not visit his doctor for check-ups. He eats terribly, mostly fatty or carbohydrate food, sugary cola, potato chips, etc. I buy about $25 worth of fruits and vegetables for him each week, but have no way of monitoring him as to whether or not he eats the food. In February, while walking into our church in the everning, he had a heart attack scare, with the fire department and ambulence taking him away to the hospital.

I offered to give him my heavier barbell and weights (since I am replacing some of the metal dumbells with vinyl weights) -- suggesting that he take up weightlifting. Yet he makes excuses not wanting to take the weights ("no room in my apartment"). He makes similar excuses as to not wanting to change his diet (and I realize high-calorie food is "cheap", such that the poor tend to load up on junk food).

Anyways, at this stage my pastor wants him to take a an evening course, a course that teaches overweight people how to lose weight (I will find the name of the course and fly it by readers in a day or so). The course costs $350 and I offered to pay for the course. This is where we are at the moment.

So it is difficult mentoring Brian. His case, I think, is one where a deternined lifestyle change could help him. Any suggestions from people would be helpful. On the rare times we walk together, he huffs and puffs, and I have to slow down to allow him to keep up with me. And I am 60 years old.
--David

Davidj, as painful and possibly harsh as this sounds, IMHO you and your pastor need to let "Brian" go, to let him live his life as he chooses, despite the exceptionally unhealthy choices he makes. That old, old saw "You can lead a horse to water but you can't make him drink" comes to mind, and only Brian can make the decision - or the many daily decisions - to get and stay healthy. At 34, he's going to do what he's going to do. And in all candor, I think your offering to pay $350.00 for Brian to take a weight-loss course is starry-eyed at best, and enabling Brian at worst. I also think you might have to confront the possibility that your and your pastor's dedication to Brian's problems are more for your own gratification than Brian's well-being.

I'll leave you with one last thought, another old old cliche': When the student is ready the teacher will appear. Brian will be ready (hopefully) in his own time, and you can certainly be there for him when he is. Until then, let him go and live your own life.

A-Jock
 

carres1973

Cathlete
Davidj - I agree with A-Jock on this one. Unfortunately, from what you described, it doesnt seem to me that "Brian" is ready and willing to change. Just as with an addict, "Brian" needs to admit he has a problem. From what you have shared, it seems Brian is not willing to put the time and effort into helping himself. Until he is, you are just throwing money into the wind and setting yourself up for disappointment. I wonder if you and your pastor can sit down with "Brian" and explain that from the experiences to date, he doesn't seem to be ready for change. As is the case with substance abuse interventions, use "I" statements to describe how the behavior makes you feel. Good luck to you Davidj. Whether obesity is a disability or disease, it is a difficult cycle to break. Add to that "Brian's" need to improve his education level and he is looking at an uphill battle. Maybe let him know you will always be there for him and for him to let you know when he is truly ready to make a change.

On a side note, maybe have him pay some or all of the price of the class. $350 is a lot of money. If "Brian" is unwilling to invest the money in himself, what does he have to lose? I realize he is on welfare but maybe he can find a thing or two to cut back on to save at least half the fee.

Good luck to you (and "Brian")!

Carrie
 

cakebaker

Cathlete
Ditto, AJock

Davidj, as painful and possibly harsh as this sounds, IMHO you and your pastor need to let "Brian" go, to let him live his life as he chooses, despite the exceptionally unhealthy choices he makes. That old, old saw "You can lead a horse to water but you can't make him drink" comes to mind, and only Brian can make the decision - or the many daily decisions - to get and stay healthy. At 34, he's going to do what he's going to do. And in all candor, I think your offering to pay $350.00 for Brian to take a weight-loss course is starry-eyed at best, and enabling Brian at worst. I also think you might have to confront the possibility that your and your pastor's dedication to Brian's problems are more for your own gratification than Brian's well-being.

I'll leave you with one last thought, another old old cliche': When the student is ready the teacher will appear. Brian will be ready (hopefully) in his own time, and you can certainly be there for him when he is. Until then, let him go and live your own life.

A-Jock

I gotta agree with A-Jock on this one. I have an obese son who will change when he is ready. He's got to weigh 300 lbs, if he weighs an ounce, on a 5'11" frame. I'm here to help when he asks for it. He knows he's fat, hates being fat, but is not ready to do something about it. His father died at 62 because of his poor life style choices, and he's headed down the same path.
 

Aquajock

Cathlete
I gotta agree with A-Jock on this one. I have an obese son who will change when he is ready. He's got to weigh 300 lbs, if he weighs an ounce, on a 5'11" frame. I'm here to help when he asks for it. He knows he's fat, hates being fat, but is not ready to do something about it. His father died at 62 because of his poor life style choices, and he's headed down the same path.

Probably the hardest part of letting someone go to make their poor / dangerous choices and experience the consequences of them, in hopes that s/he will "hit bottom" and then turn around is that . . . sometimes the bottom falls out. Many people never stop their dangerous behaviors despite the increasingly serious consequences, and many people die because of that. We all know that, and I'm sure it's that fear at the back of the brain that motivates many to try to "help" them.

Cakebaker, my mother is like your son: at 75 and about 5'5", she has to weigh at least 320 pounds, and God help you if you try even the gentlest encouragement to go to take a walk or move more than a few feet. It's truly amazing how virulently obese people will fight even the most carefully chosen words of concern or advice . . . just like the alcoholic who knows she's an alcoholic and still wants to keep drinking.

A-Jock
 

lala1

Cathlete
As someone who used to be morbidly obese, I can tell you that I did not want my doctor discussing it, since the doctor would only tell me to lose weight, but would not give me any tools or assistance to do so. Every morbidly obese person knows they need to lose weight; just telling them to do so is not even remotely helpful. Until the medical community comes up with comprehensive strategies for weight loss that actually work, they need to butt out. This is not their area of expertise. This belongs to the therapists, dietitians and fitness coaches, at least those ones that know what the hell they are doing.

I never had a single doctor ever help me with weight loss, other than to tell me I needed to lose weight. Big help. It just made me feel even worse about myself (and as someone with an eating disorder who was morbidly obese, I really didn't need another hit to my self esteem) and I just ate more and threw up more.

I don't know how long ago this was, but currently, at least in my community, the physicians offer help in addition to the "you have to lose weight". Our clinic and hospital offer a variety of programs for weight loss and even advertise these in the paper. It seems that it's matter of finding a doctor who is interested in actually helping. I have actually suggested to my DH that he change docs because *I* don't like the passive attititude his takes toward weight loss. Most of the time, whether we like it or not, patients need to advocate for ourselves and when told "you have to lose weight", need to say "how?" I'm not saying that you didn't do this, just a different perspective
 

carres1973

Cathlete
This is a very good point. I am currently going to a doctor like this. She tells me I need to lose weight and when I ask what she recommends or what she thinks would give the best results long term, she tells me to just eat one cookie out of the packet or one Hershey Kiss because that is what she does. I am just not wired like that. For me, eating is what drinking is to an alcoholic. I can't just have one! If I know it's there, I'll eat it.

That is why I think the root cause of some forms of overeating or obesity can be considered a "disease" like alcoholism...it is that obsessive, addictive tendency many of us inherit. My mother is an alcoholic. I don't drink because of this. However, in me, that addictive tendency has led to overeating which in turn has led being overweight. It is a very tough cycle to break. I am still working on it!

Carrie
 

RapidBreath

Cathlete
Actually, what I think labeling addiction a disease does is disempowers the addict- after all, if something is a disease, then they have no control over it, and therefore might as well give up, right?

No. We all have a certain amount of control over disease, thats what the placebo effect is, that is our own ability to heal ourselves.
 

Aquajock

Cathlete
This is a very good point. I am currently going to a doctor like this. She tells me I need to lose weight and when I ask what she recommends or what she thinks would give the best results long term, she tells me to just eat one cookie out of the packet or one Hershey Kiss because that is what she does. I am just not wired like that. For me, eating is what drinking is to an alcoholic. I can't just have one! If I know it's there, I'll eat it.

That is why I think the root cause of some forms of overeating or obesity can be considered a "disease" like alcoholism...it is that obsessive, addictive tendency many of us inherit. My mother is an alcoholic. I don't drink because of this. However, in me, that addictive tendency has led to overeating which in turn has led being overweight. It is a very tough cycle to break. I am still working on it!

Carrie

Boy, I can't seem to stay off this thread, can I?

In addition to the very good points noted above regarding the medical advice to "lose weight", it should be noted that comparatively very few medical doctors have any formal training in exercise science or nutrition, and judging from the physiques of many general practitioners and specialists I've seen (including those in the cardiac unit of the major hospital where my husband had heart surgery over four years ago) they have very little practical experience in exercise or healthy eating habits themselves.

It is a very, very good point to make that simply telling an obese patient to "lose weight" (which, I might add, should be stated "lose unhealthy fat stores and build muscle mass") is not enough. Don't state the problem without giving a roadmap to the solution. For crying out loud, doctors are quick enough to throw a prescription at you for every other cough, sniffle and zit you might present; you'd think they could give some concrete recommendations about an action plan. But they can't in part because they've never been required to learn.

I remember going to a family practice doctor a few years ago simply to get a prescription for a topical solution to treat "axial hyperhydrosis" (excessive sweating under the arms), and he commented on my fairly well-muscled shoulders and upper arms. He then asked, "What do you do to get those?" It was all I could do NOT to say, "Pal, if you have to ask the question, maybe your license should be reconsidered."

A-Jock
 

nancy324

Cathlete
Well said, Ajock. Our doc is always telling my DH to lose weight, but that's all she says. He hasn't a clue how to eat, and truly doesn't understand why he's overweight. I can't speak to him on the subject because it causes problems between us. But if the doc would just talk to him, I think he would listen. She promised me she would, and then forgot. Twice. :confused:
 

hiitdogs

Cathlete
I think most doctors have no clue about nutrition and exercise. It is not taught in medical school and the way our health care system works doctors make more money just prescribing a pill than actually sitting down with a patient and saying: You need to lose weight, here is why and here is how you do, check back with me in 4 weeks. How is a doctor supposed to explain this kind of stuff to you in the 5 to 10 minutes that they usually spend with a patient?

It's not how it works because we have a disease care system and not a health care system. Most doctors don't even think that nutrition plays any part in the treatment or prevention of disease.

My friend's doctor actually put him on the cookie diet. How healthy and sustainable is that? He lost 40 lbs and then gained it all back and then some. Cookie diet on doctor's orders, geez!!!

Wasn't there some time ago where a doctor got sued because he told a patient that she is fat or overweight?
 
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baylian

Cathlete
I think most doctors have no clue about nutrition and exercise. It is not taught in medical school and the way our health care system works doctors make more money just prescribing a pill than actually sitting down with a patient and saying: You need to lose weight, here is why and here is how you do, check back with me in 4 weeks. How is a doctor supposed to explain this kind of stuff to you in the 5 to 10 minutes that they usually spend with a patient?

It's not how it works because we have a disease care system and not a health care system. Most doctors don't even think that nutrition plays any part in the treatment or prevention of disease.

My friend's doctor actually put him on the cookie diet. How healthy and sustainable is that? He lost 40 lbs and then gained it all back and then some. Cookie diet on doctor's orders, geez!!!

Wasn't there some time ago where a doctor got sued because he told a patient that she is fat or overweight?


Carola - we don't agree on politics but boy do we agree on this whole idea of how nutrition and doctors lack of knowledge. I read that you lost 100 lbs also. That is most impressive. I am a fan of Natalia Rose also. I don't allows adhere but I try.
 

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